Search results for: Zarit Burden Scale

Authors: Maha Salman, Gada Al-Nuwaibit

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The effect of anti-scale magnetic method (AMM) in retarding scaling deposition is confirmed by many researchers, to result in new crystal morphology, the crystal which has the tendency to remain suspended more than precipitated. AMM is considered as an economic method when compared to other common methods used for scale prevention in desalination plant as acid treatment and addition of antiscalant. The current project was initiated to evaluate the effectiveness of AMM in preventing calcium carbonate scaling. The AMM was tested at different flow velocities (1.0, 0.5, 0.3, 0.1, and 0.003 m/s), different operating temperatures (50, 70, and 90°C), different feed pH and different magnetic field strength. The results showed that AMM was effective in retarding calcium carbonate scaling deposition, and the performance of AMM depends strongly on the flow velocity. The scaling retention time was found to be affected by the operating temperatures, flow velocity, and magnetic strength (MS), and in general, it was found that as the operating temperatures increased the effectiveness of the AMM in retarding calcium carbonate (CaCO₃) scaling increased.

Keywords: magnetic treatment, field strength, flow velocity, magnetic scale retention time

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Authors: Neslihan Karatas, Sibel Ecemis Kilic

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This paper aims to examine macro-scale plans and projects/investments which have been prepared for İzmir since The Republican Period. Macro projects that were proposed by central government, local government, industry and urban actors such as the chamber of commerce will be discussed and these projects and its reflections to the city's macro scale planning decisions will be evaluated based on existing development. Effects of macro plans, the related private and public investments, the developments of unplanned/specific projects to the current city form will be discussed. The factors and plans which determine urban form and the problems caused by unanticipated/uncontrolled developments will be evaluated. The proposals will be developed about more efficient planning process.

Keywords: Izmir, macro projects, macro investments, planning

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Authors: Asma Ben Yaghlane, Mohamed Naceur Azaiez, Mehdi Mrad

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We investigate the large scale of networks in the context of network survivability under attack. We use appropriate techniques to evaluate and the attacker-based- and the defender-based-network survivability. The attacker is unaware of the operated links by the defender. Each attacked link has some pre-specified probability to be disconnected. The defender choice is so that to maximize the chance of successfully sending the flow to the destination node. The attacker however will select the cut-set with the highest chance to be disabled in order to partition the network. Moreover, we extend the problem to the case of selecting the best p paths to operate by the defender and the best k cut-sets to target by the attacker, for arbitrary integers p,k > 1. We investigate some variations of the problem and suggest polynomial-time solutions.

Keywords: defense/attack strategies, large scale, networks, partitioning a network

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Authors: Janet Modu, Jean-Francois Georgin, Laurent Briancon, Eric Antoinet

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The current practice during the repowering phase of wind turbines is deconstruction of existing foundations and construction of new foundations to accept larger wind loads or once the foundations have reached the end of their service lives. The ongoing research project FUI25 FEDRE (Fondations d’Eoliennes Durables et REpowering) therefore serves to propose scalable wind turbine foundation designs to allow reuse of the existing foundations. To undertake this research, numerical models and laboratory-scale models are currently being utilized and implemented in the GEOMAS laboratory at INSA Lyon following instrumentation of a reference wind turbine situated in the Northern part of France. Sensors placed within both the foundation and the underlying soil monitor the evolution of stresses from the foundation’s early age to stresses during service. The results from the instrumentation form the basis of validation for both the laboratory and numerical works conducted throughout the project duration. The study currently focuses on the effect of coupled mechanisms (Thermal-Hydro-Mechanical-Chemical) that induce stress during the early age of the reinforced concrete foundation, and scale factor considerations in the replication of the reference wind turbine foundation at laboratory-scale. Using THMC 3D models on COMSOL Multi-physics software, the numerical analysis performed on both the laboratory-scale and the full-scale foundations simulate the thermal deformation, hydration, shrinkage (desiccation and autogenous) and creep so as to predict the initial damage caused by internal processes during concrete setting and hardening. Results show a prominent effect of early age properties on the damage potential in full-scale wind turbine foundations. However, a prediction of the damage potential at laboratory scale shows significant differences in early age stresses in comparison to the full-scale model depending on the spatial position in the foundation. In addition to the well-known size effect phenomenon, these differences may contribute to inaccuracies encountered when predicting ultimate deformations of the on-site foundation using laboratory scale models.

Keywords: cement hydration, early age behavior, reinforced concrete, shrinkage, THMC 3D models, wind turbines

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Authors: Kerdsiri Hongthai, Darunee Jongudomkarn, Rutja Phuphaibul

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In Thailand, many adults in rural areas migrate to seek employ¬ment resulting in skipped-generation family where grandparents care for grandchildren with no other adults present. This is a preliminary study using qualitative case study methods, aimed to explore the situations of older adult grandparents' experiences in skipped-generation family in North-East of Thailand. Data were collected by in-depth inter¬views with 6 grandparents living in skipped-generation families; 5 females and 1 males grandparents, aged 62-75, some of them have diabetes mellitus, hypertension, during November to December, 2017. The finding themes are: ‘Caught up in the middle’: the older adults were pleased to have grandchildren but, at the same time, acknowledge the burden that this placed on them, especially when the migrant children failed to send enough money back to support the family. ‘Getting bad health’: they reported to be fatigued and stressed due to burden of caring for their grandchildren without support. This situation can aggravate problems of poor health status and be worsening economic status of the grandparents. In some cases of deprivation, the grandparents feel that having to be the sole care providers of their grandchildren can negative adversely affect their mental status. It is important to find out in other sectors similar to Thailand and lead to more in-depth research to answer the research questions about policy and social support in skipped-generation family in the future.

Keywords: older adult grandparents, experiences, principle care giver, skipped-generation family

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Authors: Yu Fang Chen, Jeng Fung Hung

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This study aimed to develop a circular economy scale to assess the level of recognition among high-level executives in businesses regarding the circular economy. The circular economy is crucial for global ESG sustainable development and poses a challenge for corporate social responsibility. The aim of promoting the circular economy is to reduce resource consumption, move towards sustainable development, reduce environmental impact, maintain ecological balance, increase economic value, and promote employment. This study developed a 23-item Circular Economy Scale, which includes three subscales: "Understanding of Circular Economy by Enterprises" (8 items), "Attitudes" (9 items), and "Behaviors" (6 items). The Likert 5-point scale was used to measure responses, with higher scores indicating higher levels of agreement among senior executives with regard to the circular economy. The study tested 105 senior executives and used a structural equation model (SEM) as a measurement indicator to determine the extent to which potential variables were measured. The standard factor loading of the measurement indicator needs to be higher than 0.7, and the average variance explained (AVE) represents the index of convergent validity, which should be greater than 0.5 or at least 0.45 to be acceptable. Out of the 23 items, 12 did not meet the standard, so they were removed, leaving 5 items, 3 items, and 3 items for each of the three subscales, respectively, all with a factor loading greater than 0.7. The AVE for all three subscales was greater than 0.45, indicating good construct validity. The Cronbach's α reliability values for the three subscales were 0.887, 0.787, and 0.734, respectively, and the total scale was 0.860, all of which were higher than 0.7, indicating good reliability. The Circular Economy Scale developed in this study measures three conceptual components that align with the theoretical framework of the literature review and demonstrate good reliability and validity. It can serve as a measurement tool for evaluating the degree of acceptance of the circular economy among senior executives in enterprises. In the future, this scale can be used by senior executives in enterprises as an evaluation tool to further explore its impact on sustainable development and to promote circular economy and sustainable development based on the reference provided.

Keywords: circular economy, corporate social responsibility, scale development, structural equation model

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Authors: Sezen Gulec, Bilge Uzun

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Almost all of the world population marries at least once in their lifetime. Nevertheless, in reality, only half of all marriages last a lifetime. The most important factor in marriage to manage is the satisfaction that they obtain. It is reality that marital satisfaction does not only related to maintain the relationship but also related to the social and work relationships. In this respect, the purpose of the present research is to find the personal and relational factors predicted marital satisfaction. The sample including 378 (178 male and 200 females) married individuals were administered to marital life scale, multidimensional perfectionism scale, trait forgivingness scale, adjective based personality test and relationship happiness questionnaire. The findings revealed marital happiness, forgiveness and extravertedness and emotional inconsistency factors were found to be significant predictors of marital satisfaction.

Keywords: marital satisfaction, happiness, perfectionism, forgiveness, five factor personality

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Authors: Min-Pei Ling

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Aflatoxin is a fungal secondary metabolite with high toxicity capable of contaminating various types of food crops. It has been identified as a Group 1 human carcinogen by the International Agency for Research on Cancer. Chronic aflatoxin exposure has caused a worldwide public food safety concern. Peanuts and peanut products are the major sources of aflatoxin exposure. Therefore, some reduction interventions have been developed to minimize contamination through the peanut production chain. The purpose of this study is to estimate the efficacy of interventions in reducing the health impact of hepatocellular carcinoma caused by aflatoxin contamination in peanuts. The estimated total disability-adjusted life-years (DALYs) was calculated using FDA-iRISK online software. Six aflatoxin reduction strategies were evaluated, including good agricultural practice (GAP), biocontrol, Purdue Improved Crop Storage packaging, basic processing, ozonolysis, and ultraviolet irradiation. The results indicated that basic processing could prevent huge public health loss of 4,079.7–21,833 total DALYs per year, which accounted for 39.6% of all decreased total DALYs. GAP and biocontrol were both effective strategies in the farm field, while the other three interventions were limited in reducing total DALYs. In conclusion, this study could help farmers, processing plants, and government policymakers to alleviate aflatoxin contamination issues in the peanut production chain.

Keywords: aflatoxin, health burden, disability-adjusted life-years, peanuts

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Authors: B. Daee, H. M. El Naggar

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This paper presents an experimental study on structural performance of an innovative noise barrier consisting of poly-block, light polyurethane foam (LPF) and polyurea. This wall system (flexi-wall) is intended to be employed as a vertical extension to existing sound barriers in an accelerated construction method. To aid in the wall design, several mechanical tests were conducted on LPF specimens and two full-scale walls were then fabricated employing the same LPF material. The full-scale walls were subjected to lateral loading in order to establish their lateral resistance. A cyclic fatigue test was also performed on a full-scale flexi-wall in order to evaluate the performance of the wall under a repetitive loading condition. The result of the experiments indicated the suitability of flexi-wall in accelerated construction and confirmed that the structural performance of the wall system under lateral loading is satisfactory for the sound barrier application. The experimental results were discussed and a preliminary design procedure for application of flexi-wall in sound barrier applications was also developed.

Keywords: noise barrier, polyurethane foam, accelerated construction, full-scale experiment

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Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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Authors: Hamidreza Sahaleh

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Because of the stringent prerequisite of low sulfur and heavier raw oil feedstock more hydrogen will be devoured in the refineries. Specifically if huge scale limits are the reaction to an expanded hydrogen request, certain configuration and building background are obliged with, which will be depicted in this paper with an illustration. Chosen procedure plan prerequisite will be recorded and portrayed in agreement to the flowsheet. Also, a determination of imaginative outline elements, similar to process condensate reuse, safe reformer start up and prerequisites will be highlighted.

Keywords: low sulfur, raw oil, refineries, flowsheet

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Authors: Tingting Huang, Sha Li, Geoffrey Griffiths, Martin Lukac, Jianning Zhu

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Territorial landscapes have experienced a gradual loss of their typical characteristics during long-term human activities. In order to protect the integrity of regional landscapes, it is necessary to characterize, evaluate and protect them in a graded manner. The study takes Fujian, China, as an example and classifies the landscape characters of the site at the regional scale, middle scale, and detailed scale. A multi-scale approach combining parametric and holistic approaches is used to classify and partition the landscape character types (LCTs) and landscape character areas (LCAs) at different scales, and a multi-element landscape assessment approach is adopted to explore the conservation strategies of the landscape character. Firstly, multiple fields and multiple elements of geography, nature and humanities were selected as the basis of assessment according to the scales. Secondly, the study takes a parametric approach to the classification and partitioning of landscape character, Principal Component Analysis, and two-stage cluster analysis (K-means and GMM) in MATLAB software to obtain LCTs, combines with Canny Operator Edge Detection Algorithm to obtain landscape character contours and corrects LCTs and LCAs by field survey and manual identification methods. Finally, the study adopts the Landscape Sensitivity Assessment method to perform landscape character conservation analysis and formulates five strategies for different LCAs: conservation, enhancement, restoration, creation, and combination. This multi-scale identification approach can efficiently integrate multiple types of landscape character elements, reduce the difficulty of broad-scale operations in the process of landscape character conservation, and provide a basis for landscape character conservation strategies. Based on the natural background and the restoration of regional characteristics, the results of landscape character assessment are scientific and objective and can provide a strong reference in regional and national scale territorial spatial planning.

Keywords: parameterization, multi-scale, landscape character identify, landscape character assessment

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Authors: Sonia Barbouchi, Meriem Samcha

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Scale deposition during water injection into aquifer of oil reservoirs is a serious problem experienced in the oil production industry. One of the primary causes of scale formation and injection well plugging is mixing two waters which are incompatible. Considered individually, the waters may be quite stable at system conditions and present no scale problems. However, once they are mixed, reactions between ions dissolved in the individual waters may form insoluble products. The purpose of this study is to identify the causes of well plugging in a southern Tunisian oilfield, where fresh water has been injected into the producing wells to counteract the salinity of the formation waters and inhibit the deposition of halite. X-ray diffraction (XRD) mineralogical analysis has been carried out on scale samples collected from the blocked well. Two samples collected from both formation water and injected water were analysed using inductively coupled plasma atomic emission spectroscopy, ion chromatography and other standard laboratory techniques. The results of complete waters analysis were the typical input parameters, to determine scaling tendency. Saturation indices values related to CaCO3, CaSO4, BaSO4 and SrSO4 scales were calculated for the water mixtures at different share, under various conditions of temperature, using a computerized scale prediction model. The compatibility study results showed that mixing the two waters tends to increase the probability of barite deposition. XRD analysis confirmed the compatibility study results, since it proved that the analysed deposits consisted predominantly of barite with minor galena. At the studied temperatures conditions, the tendency for barite scale is significantly increasing with the increase of fresh water share in the mixture. The future scale inhibition and removal strategies to be implemented in the concerned oilfield are being derived in a large part from the results of the present study.

Keywords: compatibility study, produced water, scaling, water injection

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Authors: Azlin Mohd Azmi, Tongming Zhou, Akira Rinoshika, Liang Cheng

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The turbulent structures in the wake (x/d =10 to 60) of a screen cylinder have been reduced to understand the roles of the various structures as evolving downstream by comparing with those obtained in a solid circular cylinder wake at Reynolds number, Re of 7000. Using a wavelet multi-resolution technique, the flow structures are decomposed into a number of wavelet components based on their central frequencies. It is observed that in the solid cylinder wake, large-scale structures (of frequency f0 and 1.2 f0) make the largest contribution to the Reynolds stresses although they start to lose their roles significantly at x/d > 20. In the screen cylinder wake, the intermediate-scale structures (2f0 and 4f0) contribute the most to the Reynolds stresses at x/d =10 before being taken over by the large-scale structures (f0) further downstream.

Keywords: turbulent structure, screen cylinder, vortex, wavelet multi-resolution analysis

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Authors: Naresh Radaliyagoda, Nigel M. Jennett, Rong Lan, David Parfitt

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A series of length scale engineered multilayer material with temperature robust mechanical properties has been suggested. A range of polycrystalline copper sub-layers with the thickness varying from 1 to 25μm and buried in between two nickel layers was produced using electrodeposition dual bath technique. The structure of the multilayers was characterized using Electron Backscatter Diffraction and Scanning Electron Microscope. The interface effect on the hardness and elastic modulus was tested using Nano-indentation. Results of the grain size and layer thickness measurements, and indentation hardness have been compared. It is found that there is a combined length scale effect that improves mechanical properties in Ni/Cu multilayer structures.

Keywords: nano-indentation, size effect, multilayers, electrodeposition

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Authors: Yusuf Yasa, Erkan Mese

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This paper investigates the thermal issue of permanent magnet synchronous generator which is frequently used in direct drive gearless small-scale wind turbine applications. Permanent magnet synchronous generator (PMSG) is designed with 2.5 kW continuous and 6 kW peak power. Then considering generator geometry, mechanical design of wind turbine is performed. Thermal analysis and optimization is carried out considering all wind turbine components to reach realistic results. These issue is extremely important in research and development(R&D) process for wind turbine applications.

Keywords: direct drive, gearless wind turbine, permanent magnet synchronous generator (PMSG), small-scale wind turbine, thermal management

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Authors: E. E. Marschalko, K. Kalcza-Janosi, I. Kotta, B. Bibok

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Cultural moderation aspects have been highlighted in the literature on self-determination behavior in some cultures, including in the Hungarian population. There is a lack of validated instruments in Hungarian for the assessment of self-determination related behaviors. In order to fill in this gap, the aim of this study was the translation, cultural adaptation and validation of Self Determination Scale (Sheldon, 1995) for the Hungarian population. A total of 4335 adults participated in the study. The mean age of the participants was 27.97 (SD=9.60). The sample consisted mostly from females, less than 20% were males. Exploratory and confirmatory factor analyses were performed for adequacy checking. Cronbach’s alpha was used to examine the reliability of the factors. Our results revealed that the Hungarian version of SDS has good psychometric properties and it is a reliable tool for psychologist who would like to study or assess self-determination in their clients. The final, adapted and validated SDS items are presented in this paper.

Keywords: self-determination scale, Hungarian, adaptation, validation, reliability

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Authors: Ofelia Loani Elvir Lazo, Roya Yumul, David Chernobylsky, Omar Durra

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Background: It is crucial to detect the patient’s existing anxiety to assist patients in a perioperative setting which is to be caused by the fear associated with surgical and anesthetic complications. However, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting, given the duration and concentration required to complete the 40-item questionnaire. Our primary aim in the study is to investigate the correlation of the Yumul Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparative analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusıons: Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul Faces Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul Faces Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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Authors: Hamna Hamid, Kashmala Zaman

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The aim of this study was to evaluate the relationship between self-efficacy, resilience and social support among clinical psychologists, counselors and teachers of special schools. The study also assesses the gender differences on self-efficacy, resilience, social support and vicarious trauma and also vicarious trauma differences among three professions i.e. clinical psychologists, counselors and teachers of special schools. A sample of 150 women and 97 men were handed out a set questionnaire to complete: General Self-Efficacy Scale, Brief Resilience Scale, Multidimensional Scale of Perceived Social Support and Vicarious Trauma Scale. Results showed that there is significant negative correlation between self-efficacy, resilience and vicarious trauma. Women experiences higher levels of vicarious trauma as compared to men. While clinical psychologists and counselors experience higher levels of vicarious trauma as compared to teachers of special schools. Moderation effect of social support is not significant towards resilience and vicarious trauma.

Keywords: self-efficacy, resilience, vicarious trauma, social-support

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Authors: Eva Čáslavová, Andrej Višněvský

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This research focused on the dimensions of brand personality of the Ice Hockey World Championship sporting event. The authors compared the elements in relation to different demographic groups including gender, age, level of education and student status of the population of Prague. Moreover, the differences of opinions of respondents who had experience of visiting a sports event and those who had not were assessed. In the research, the modified brand personality scale was used. This modified scale consists of five dimensions: responsibility, activity, toughness, individuality and emotionality, none of which was previously tested. The authors had an intentional sample of 291 respondents from Prague available, ranging in age from 18 years to 75 years, with either a high school or university education. The respondents rated the characteristic features in a seven-point Likert Scale and the data was collected in November 2012. The results suggest that the Ice Hockey World Championship is most identified with these dimensions: responsibility, emotionality and activity. Men had higher mean scores (4.93) on the Likert Scale in the emotionality dimension, while women had higher mean scores (4.91) in the activity dimension. Those respondents with experience visiting an Ice Hockey World Championship match had the highest mean score (5.10) in the emotionality dimension. This research had expected to show more pronounced mean values (above six) on the Likert scale in the emotionality and activity dimensions that more strongly characterize the brand personality of the Ice Hockey World Championship, however this expectation was not confirmed.

Keywords: dimensions, brand personality, ice hockey, international sports event, marketing

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Authors: Hana Rabbouch

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In recent years, there has been considerable growth of denoising techniques mainly devoted to medical imaging. This important evolution is not only due to the progress of computing techniques, but also to the emergence of multi-resolution analysis (MRA) on both mathematical and algorithmic bases. In this paper, a comparative study is conducted between the two best-known MRA-based decomposition techniques: the Empirical Mode Decomposition (EMD) and the Discrete Wavelet Transform (DWT). The comparison is carried out in a framework of multi-scale denoising, where a Non-Local Means (NLM) filter is performed scale-by-scale to a sample of benchmark medical images. The results prove the effectiveness of the multiscaled denoising, especially when the NLM filtering is coupled with the EMD.

Keywords: medical imaging, non local means, denoising, multiscaled analysis, empirical mode decomposition, wavelets

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Authors: Karim Hajjar, Luis Lillo, Diego Martinez, Manuel Hermosilla, Nicholas Risko

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Objectives: This study examines the relationship between universal health coverage (UCH) and the burden of emergency diseases at a global level. Methods: Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables, 1) coverage of essential health services and 2) proportion of population spending more than 10% of household income on out-of-pocket health care expenditure, was extracted from the World Bank Database for years preceding our outcome of interest. Linear regression was performed, analyzing the effect of the UHC variables on the DALYs of emergency diseases, controlling for other variables. Results: A total of 133 countries were included. 44.4% of the analyzed countries had coverage of essential health services index of at least 70/100, and 35.3% had at least 10% of their population spend greater than 10% of their household income on healthcare. For every point increase in the coverage of essential health services index, there was a 13-point reduction in DALYs of emergency medical diseases (95% CI -16, -11). Conversely, for every percent decrease in the population with large household expenditure on healthcare, there was a 0.48 increase in DALYs of emergency medical diseases (95% CI -5.6, 4.7). Conclusions: After adjusting for multiple variables, an increase in coverage of essential health services was significantly associated with improvement in DALYs for emergency conditions. There was, however, no association between catastrophic health expenditure and DALYs.

Keywords: emergency medicine, universal healthcare, global health, health economics

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Authors: Mahmoud F. Mohamadin, Ahmed Abdel Malek, Wessam Said

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Achieving energy efficient architecture in general, and in emerging countries in particular, is a challenging process that requires the contribution of various governmental, institutional, and individual entities. The rule of architectural design is essential in this process as it is considered as one of the earliest steps on the road to sustainability. Architectural firms have a moral and professional responsibility to respond to these challenges and deliver buildings that consume less energy. This study aims to evaluate the design processes and tools in practice of Egyptian architectural firms based on a limited survey to investigate if their processes and methods can lead to projects that meet the Egyptian Code of Energy Efficiency Improvement. A case study of twenty architectural firms in Cairo was selected and categorized according to their scale; large-scale, medium-scale, and small-scale. A questionnaire was designed and distributed to the firms, and personal meetings with the firms’ representatives took place. The questionnaire answered three main points; the design processes adopted, the usage of performance-based simulation tools, and the usage of BIM tools for energy efficiency purposes. The results of the study revealed that only little percentage of the large-scale firms have clear strategies for building energy efficiency in their building design, however the application is limited to certain project types, or according to the client request. On the other hand, the percentage of medium-scale firms is much less, and it is almost absent in the small-scale ones. This demonstrates the urgent need of enhancing the awareness of the Egyptian architectural design community of the great importance of implementing these methods starting from the early stages of the building design. Finally, the study proposed recommendations for such firms to be able to create a healthy built environment and improve the quality of life in emerging countries.

Keywords: architectural firms, emerging countries, energy efficiency, performance-based simulation tools

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Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

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Authors: Des Lambley

Abstract:

The scope and scale of crime in the AIF is a subject largely overlooked by historians preferring to narrate the macro-scale topics. This examination exposes some 17,000 military criminals, 414 of them officers and illustrates how military law imposed itself. This subjective sociological perspective humanises the impacts of war upon soldiers. Examples of the crimes, their seriousness, punishments and military justice tell of cause and effect linkages between crime, stress and illness. The discourse is derived from original official military sources in the Australian Archives.

Keywords: Australia, AIF, Military Crime, WW1, Officers

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Authors: Henrik Prinzhorn, Peter Nyhuis, Johannes Wagner, Peter Burggräf, Torben Schmitz, Christina Reuter

Abstract:

Assembling large-scale products, such as airplanes, locomotives, or wind turbines, involves frequent process interruptions induced by e.g. delayed material deliveries or missing availability of resources. This leads to a negative impact on the logistical performance of a producer of xxl-products. In industrial practice, in case of interruptions, the identification, evaluation and eventually the selection of an alternative order of assembly activities (‘assembly alternative’) leads to an enormous challenge, especially if an optimized logistical decision should be reached. Therefore, in this paper, an innovative, optimization model for the identification of assembly alternatives that addresses the given problem is presented. It describes make-to-order, large-scale product assembly processes as a resource constrained project scheduling (RCPS) problem which follows given restrictions in practice. For the evaluation of the assembly alternative, a cost-based definition of the logistical objectives (delivery reliability, inventory, make-span and workload) is presented.

Keywords: assembly scheduling, large-scale products, make-to-order, optimization, rescheduling

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Authors: Amit Kumar Dwivedi, Priyanko Ghosh

Abstract:

Data Envelopment analysis (DEA) has been used to calculate the technical and scale efficiency measures of the public and private sugar manufacturing firms of the Indian Sugar Industry (2006 to 2010). Within DEA framework, the input & Output oriented Variable Returns to Scale (VRS) & Constant Return to Scale (CRS) model is employed for the study of Decision making units (DMUs). A representative sample of 43 firms which account for major portion of the total market share is studied. The selection criterion for the inclusion of a firm in the analysis was the total sales of INR 5,000 million or more in the year 2010. After reviewing the literature it is found that no study has been conducted in the context of Indian sugar manufacturing firms in the Post-liberalization era which motivates us to initiate the study.

Keywords: technical efficiency, Indian sugar manufacturing units, DEA, input output oriented

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Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

Abstract:

Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

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Authors: Thanunthon Bowornsakulwong, Charukorn Charukarn, Franck Courtes, Panit Kitsubun, Lalintip Horcharoen

Abstract:

Vero cell is a continuous cell line that is widely used for the production of viral vaccines. However, due to its adherent characteristic, scaling up strategy in large-scale production remains complicated and thus limited. Consequently, suspension-like Vero cell culture processes based on microcarriers have been introduced and employed while also providing increased surface area per volume unit. However, harvesting Vero cells from microcarriers is a huge challenge due to difficulties in cells detaching, lower recovery yield, time-consuming and dissociation agent carry-over. To overcome these problems, we developed a dissociation-association platform technology for detaching and re-attaching cells during subculturing from microcarriers to microcarriers, which will be conveniently applied to seed trains strategies in large scale bioreactors. Herein, Hillex-2 was used to culture Vero cells in serum-containing media using spinner flasks as a scale-down model. The overall confluency of cells on microcarriers was observed using inverted microscope, and the sample cells were daily detached in order to obtain the kinetics data. The metabolites consumption and by-products formation were determined by Nova Biomedical BioprofileFlex.

Keywords: dissociation-reassociation, microcarrier, scale up, Vero cell

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